Breast x-ray apparatus with means to accurately position the body of a patient



Jan. 23, 1968 P. STRAX BREAST X--RAY APPARATUS WITH APPARATUS WITH MEANSTO ACCURATEIJY POSITION THE BODY OF A PATIENT Filed 1380.. 10, 1964 v vMIMI] ENTOR, PHILIP STRAX ATTORNEYS United States Patent s ass s75annasr X-RAY APPARATUS wrrn MEANS To lg cgaa'rmv restricts Tun noun or Ai NT Philip Strax, Great Neck, N.Y., assignor to Charles &

ABSTRACT UP THE DESCLOSURE There is disclosed in the instant applicationa mobile breast X-ray unit adapted to expedite the taking of X- raypictures of breasts and therefore equipment which makes it possible totake mass X-rays, as for example, in an X-ray clinic.

Furthermore, the invention disclosed provides for the mounting of allequipment on a single mobile dolly with the tube screen and camera on acommon vertical axis and with a means for varying the height of a standon which the patient stands so that the breast support member located onthe same vertical axis properly supports a breast, whereupon the cameramay be moved into position to gently press the breast between aradiation shiel ing cone on the camera and the support surface.

This invention relates to medical X-ray equipment, and more particularlyto an apparatus and method for X-ray examination to detect breast cancerand related types of breast growths and defects.

Breast cancer is today the most prevalent form of cancer afilictingWomen in the United States. It has long been known that when detectedearly in its development, it can be more successfully treated. X-rayexamination is a principal method for detecting breast cancer in itsearly stages.

The conventional breast-X-ray examination technique is to first positionthe patient in vertical and prone positions on an examination table. TheX-ray sensitive film pack is located beneath the patients breast. TheX-ray tube used to sensitize the film is movably positioned above thepatient and table. After the patient is positioned on the table with herbreast above the film, the X-ray tube is then moved into position andlocated to focus the X-ray image of the patients breasts on the film.Proper positioning of the X-ray tube and patient relative to the tableand film requires time and skill. It may also cause considerableinconvenience to the patient. The energies used involve large generatorsand heavy stationary equipment. For these reasons conventionaltechniques do not lend themselves to mass breast X-ray work of a largenumber of patients on an expedited examination schedule as, for example,in a mobile breast X-ray clinic.

Because of the importance of early detection in breast cancer treatment,doctors and public health authorities have sought a mass X-ray techniquewhereby large numbers of Women could be examined quickly, simply andinexpensively. The apparatus and method disclosed herein meet theserequirements.

In my invention an X-ray tube, fluorescent screen, camera and patientplatform are all mounted on a single ice mobile dolly. The tube, screenand camera are disposed along a vertical axis. The patient simply walksup to and steps onto the platform and positions alternately each breastbetween the tube and the screen and camera below the screen. The X-raytube is then energize-d to emit X- rays through the patients breast andonto the fluorescent screen. The screen is thus sensitized to produce animage of the breast. This image is simultaneously photographed on filmlocated in the camera below the screen.

The platform on which the patient stands is vertically adjustable topermit raising or lowering of the patient with respect to the screen andtube to correctly position the patients breasts relative to the screenand tube. The tube assembly may be lowered to gently compress thepatients breast between a radiation shielding cone on the tube and atable directly above the screen so as to flatten the patients breastabove the screen. This shields the patient from stray radiation andequalizes breast density for better film detail.

Because the patient simply walks up and stands in position for the X-rayexamination, and due to the fact that the tube need only be loweredslightly to compress the patients breast for each picture, the machineembodied in this invention is particularly well suited for mass X-rayuse.

It is therefore a principal object of my invention to provide a meansand method for quickly and conveniently X-raying patients for breastcancer on a mass patient basis.

It is another object of my invention to provide a simple and convenientmethod and means for positioning a patient relative to a verticallydisposed X-ray tube, screen and camera arrangement for breast X-rayexamination.

It is another object of my invention to provide a method and means forpositioning a patient and the patients breast for X-ray examination,wherein the pav tients breast is gently compressed so as to spread thebreast for an optimum field of examination.

It is another object of my invention to provide a method and means forproducing X-rays of the breast with a minimum of radiation dose. This ispossible because of the efliciency of the screen fluorescence by theX-ray beam and the efiiciency of the camera in reproducing this image onphotographic film.

Other objects of my invention not at this time more particularlyenumerated will be apparent from the accompanying description anddrawing, which is a side elevation in partial section of an apparatusembodying my invention.

Referring to the drawing, my apparatus is preferably mounted on mobiledolly it which rolls about on the floor on wheels 12.

X-ray tube 14 is pivotally mounted to pinion 15 about a horizontal axisin Y-shaped yoke 16. Base 17 of yoke 16 is journalled into mountingblock 18 to permit free rotation about a horizontal axis perpendicularthe axis of pinion 15. Mounting block 13 is movably attached to upright24) which is rigidly gussete-d to platform 10. Block 13 is tracked inguide 19 which is mounted on upright 2t} and may be raised or loweredrelative to upright 28 by a variety of conventional drives, such as anelectric motor driven worm and rack arrangement. This mountingarrangement permits the necessary freedom of movement required forinitially setting up and aiming tube 14 and compressing the p-atientsbreast as explained below.

Also mounted to upright is control panel 21 having control knobs 22which control the output and elevation of tube 14.

Tie specific design of X-ray tube 1- 2 and control panel '21 used in myapparatus is not a part of my invention. Any of a variety ofconventional tubes and panels might be used. Tube 14 should be adaptedfor projecting of the X-ray beam along a substantially vertical axis. Itshould also be relatively light, since this contributes to the stabilityof the complete apparatus.

Attached directly to the bottom of tube 14 is radiation shielding cone22, which prevents the scatter of X-rays to other parts of the patientsbody while the X-ray examination is made. Cone 22 is made of suitableshielcing material such as lead or copper and preferably shaped with aflattened surface 23 on the side facing the patient being examined and afiat 24- at the base of the cone. Flat 23 is shaped so as to permit thepatient to rest her upper chest against it while fiat 24 gently pressesdown on the patients breast during the examination.

Another principal element of my apparatus is the fluorescent screen andcamera unit generally designated 30, which is mounted and rigidlypositioned on platform 10 by stanchions 31.

The top exterior of unit is breast support table 32 on which thepatients breast is positioned for the X-ray examination. Table 32 ismade of thin material which does not impede the passage of radiationfrom X-ray tube 14. While a flat surface is shown, any suitable breastpositioning surface may be used for table 32. As pointed out above, tube14- and cone 22 are lowered during the examination to gently compressthe patients breast between fiat 24 and table 32. This spreads thebreast, enlarges the examination field for each breast and provides moreeven density.

Directly below table 32 is an X-ray sensitive fluorescent screen 33which fiuoresces when sensitized by X-rays emitted by tube 14. By thismeans a luminous image of the breast being examined is produced onscreen 33.

This image on screen 33 is photographed by camera 34 which is positioneddirectly below screen 33. Camera 34 focuses the image and positions thefilm used for each X-ray picture in a conventional way. At one side ofcamera 34 is roll-film magazine 36 which holds fresh film, and on theopposite side is roll-film magazine 38 which holds the exposed film. Thefilm travels from magazine 36 to and through housing 46 below and inline with th screen 33, table 32 and tube 14, at which location the filmis exposed. The exposed film then returns to magazine 38.

Screen 33 and camera 34 may be conventional X-ray equipment. Preferablycamera 34 is adapted for mass breast survey work, that is, one which canhold a long unperforated X-ray roll-film having room for four to fivehundred exposures. Magazines 36 and 38 are preferably mounted on theoutside of camera 34 in a way to facilitate convenient removal andreloading. Similarly, screen 33 is preferably one which is adapted tomass breast survey examination, having the capability of producing sharpimages on a large number, repetitive basis with a minimum of upkeep.

As pointed out above, tube 14, table 32, screen 33 and camera 34 arepositioned at a substantially fixed distance relative to each other whenproperly set for each examination. Tube 14 may be raised or lowered andadjusted slightly by pivoting about pinion 15 to align the axis ofradiation emanating from tube 14, but this does not appreciably vary itsdistance from table 32, screen 33 and camera 34. These distances areselected to obtain sharp focus of the X-ray image of the patients breastwhen it is positioned on table 32. Thus, once these distances arecalculated, tube 34, table 32 and camera 34 remain in a fixed positionand need not be adjusted for each examination. Means to compensate forthe difference in height of the patients being examined are provided, aswill now be explained.

Directly adjacent camera housing 30 and mounted on platform It? ispedestal 42, on which the patient stands while the X-ray picture isbeing taken. Pedestal 42 is provided with a power supply (not shown)which raises or lowers pedestal 42 to the desired height. It is notmaterial Whether this power supply is hydraulic, pneumatic orelectrical, so long as it can raise or lower pedestal 42 through a fulltraverse of about one foot. In this way, the patients position may beadjusted relative to X-ray tube 14, screen 33 and camera 34 to permitthe patient to conveniently position her breasts on table 32.

In operation the patient approaches and stands on pedestal 42. Theoperator then raises or lowers pedestal 42 by varying the appropriatecontrol on panel 21 to locate the patient so that she may convenientlyposition each breast on table 32. The desired power output is then setby the operator by adjusting the appropriate control on panel 21. Thepatient then rests one breast on table 32 with her upper chest againstflat surface 23 of cone 22. The operator then lowers tube 14 and cone 22until the breast to be examined is gently compressed between flat 24 ofcone 22 and table 32. The operator then energizes tube 14 to make theexposure, and camera 34 photographs the image on screen 33 andautomatically advances the exposed portion of the film to magazine 38,and fresh film is automatically loaded into position for the nextexposure from magazine 36. The operation may then be repeated for thenext exposure. Care must be taken to positively identify each exposurewith each patient. There are many ways well known in the radiography artfor doing this.

While this description has dealt primarily with one specific embodimentof my invention, it should be understood that modifications andimprovements which would be apparent to those skilled in the art can bemade to the apparatus disclosed herein and still be within the scope ofmy invention. For example, conventional fluoroscopic examination mightbe substituted for the disclosed X-ray camera arrangement. Furthermore,the X-ray tube, tluorescent screen and camera of my apparatus might bemounted to a wall rather than on an upright post connected to a dolly,and the movable patients platform positioned in front of that Wall.Alternatively, these units may be mounted coaxially on axes other thanvertical. Therefore, while this description has concentrated on apreferred embodiment of the invention, it will be unde stood that thedisclosed invention is not to be limited by the foregoing descriptionbut solely by the claims granted.

What is claimed is:

1. A breast X-ray device comprising in combination (a) an X-ray sourceand housing for such source,

(b) an X-ray cone connected to and depending downwardly from the X-rayhousing,

(0) an X-ray transparent lateral breast support surface spaced below theX-ray cone,

(i) said cone having at its lower end an X-ray transparent lateralsurface which conforms generally to the shape of said breast supportsurface,

(d) photofiuorographic camera means breast support surface,

(e) patient lift stand adjacent to the above claimed elements forpositioning a patient and thereby a patients breast to the height of thebreast support surface, and

(f) means for mounting the above claimed elements,

comprising (i) means for aligning and maintaining alignment of the X-raysource, X-ray cone and lower surface, breast support surface andphototluorographic camera means on a substantially vertical axis,

below said (ii) means for varying the distance of the X-ray sourcehousing and cone above the breast support surface along said axis anamount sufiicient to gently compress and spread a patients breastbetween the cones lower lateral surface and the breast support surfacein the close position of such varying means and to release the breastfrom all restraint in the open position of such distance varying means,and

(iii) means for modifying the height of said patient lift stand relativeto said breast support surface.

2. A breast X-ray device as claimed in claim 1 wherein said mountingmeans further comprises a mobile dolly on which all of said elements aremounted.

3. A breast X-ray device as claimed in claim 1 wherein said mountingmeans comprises a vertical upright having vertical guide means on whichthe X-ray source and cone are movably mounted, said breast supportsurface and photofluorographic camera means being positioned relative tosaid upright so as to be aligned with the X-ray source and cone throughthe full traverse of such source and cone on the guide means.

References Cited UNITED STATES PATENTS 1,074,120 9/1913 Hutton 250-582,953,683 9/1960 Guntert 250-65 3,150,260 9/1964 Smith 25050 OTHERREFERENCES RALPH G. NILSON, Examiner.

